Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Country Club Dental PA

Organization General Practice Dentistry · NPI 1699137109

Country Club Dental PA provides General Practice Dentistry in Topeka, Kansas. Licensed in Kansas. Registered with an NPI since 2016.

Licensed in
KS
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

400 SW 29th St Ste M
Topeka, KS 66611-1164
Phone: (785) 783-5981
Fax: (785) 783-5982
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X (KS)
General Practice Dentistry Taxonomy 1223G0001X

Record details

NPI number1699137109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shaun Urbanozo — Credentialing Manager · (719) 323-2362
Other names Adventure Dental And Vision; Adventure Dental And Vision
NPI enumeratedMarch 23, 2016
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing address2221 E Bijou St, Ste 100, Colorado Springs, CO 80909-8009

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